Preventative medicine is basically treating a person before they get sick or decreasing the chances of a person becoming sick - changing diet, active lifestyle, regular checkups, etc. Current medicine is based on treatment of the sick, ie - you've got clogged arteries, then we'll go put in a stent. The idea behind the prevention is to try to make it so that you don't get to this point. It requires active participation by the physician and the patient. So yes, people that don't care of themselves make it worse for everyone else because they take up time, resources, etc. People need to want to take care of themselves, but do we force them to by raising their premiums? I don't know.
I'm not really sure what happened in the 80s so perhaps you could give me some background on that. I'm sure you didn't mean to, but please don't generalize and call physicians greedy - some of them are and there are bad physicians out there, but the overwhelming majority of them truly want to help and have been handcuffed by the system.
Recently there have been many steps taken by the AMA and other groups to improve the quality of care delivery. The younger generation especially is making this happen. You now have physicians taking stands against the "free lunches" that pharma sales people give out in an effort to get their drugs purchased - which to me is a huge step. Pharma, health insurance companies, and society need to get on board as well to drive the change.